Bennington Place II HOA Change Request

Name/Owner: *
Address: *
Home Phone:
Work Phone:
Email Address: *
Type of Improvement: *
 Fence 
 Landscape 
 Satellite Dish 
 Storm Door 
 Sign/Flag 
 Addition/Alteration 
Please check one. Each improvement requires a separate application.
Please provide a brief description of the improvement: *
Attach a letter below if necessary.
Description Attachments:

Please attach all pertinent drawings and information to include: Surveys, architectural drawings, renderings, and manufacturer information:

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e-Signature - Applicant's Name and Today's Date: *

Disclaimer: Owner assumes all responsibility for future repairs to building/structure needed due to installation of any improvement.

A copy of this form will be returned as soon as possible. There is no automatic
approval – DO NOT begin any work until written approval is received!

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